Association among Terminally Differentiated T Cells, Frailty, and Dependency in a Group of Cuban Centenarians.

INTRODUCTION: Centenarians are considered a model of successful aging. Cuba exhibits one of the oldest populations in Latin America with more than two thousand centenarians. METHODS: This study aimed to evaluate the immune phenotype of forty-three Cuban centenarians, their clinical characteristics such as comorbidities, frailty, body mass index, and some hemochemical parameters. RESULTS: Centenarians had normal body mass indexes, relatively good health status, and 21.95% of them had no comorbidities; 53.6% were classified as frail, and 7% were classified as robust. In addition, 17% of centenarians were independent, and 41.46% were moderately dependent. The seroprevalence against cytomegalovirus was 100%. Concerning pro-inflammatory markers, the majority of them had very low cytokine levels and serum C-reactive protein around the normal limit. We also found the predominance of memory subsets over naive compartments in CD4+ and CD8+ T cells. Terminally differentiated CD8+CD28- T cells were higher in frail centenarians than in pre-frail, while CD8+CD57+ and CD8+EMRA T cells were higher in moderately and severely dependent individuals than in independent individuals. Severely dependent centenarians had a lower CD4+/CD8+ ratio. CONCLUSION: This study describes for the first time the predominance of memory subsets over naive compartments in CD4+ and CD8+ T cells, as well as its relation to frailty and/or dependency in a group of Cuban centenarians. Further studies are needed to continue understanding the natural biological aging mechanism and the relationship between terminally differentiated lymphocytes and inflammaging in the context of extreme longevity.

Testosterone Levels Are Decreased and Associated with Disease Duration in Male Spinocerebellar Ataxia Type 2 Patients.

Spinocerebellar ataxia type 2 (SCA2) is a progressive neurodegenerative disorder due to an unstable expansion of a CAG repeat in the ATXN2 gene. Despite clinical and experimental evidence indicating the relevance of the gonadotropic axis to the prognosis and therapeutics for several late-onset neurodegenerative disorders, its functioning and association with disease severity have not been previously explored in SCA2. To assess serum levels of testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), and their clinical relevance in SCA2 patients. A case-control study involving 94 Cuban SCA2 patients and 101 gender- and age-matched healthy controls was conducted. Testosterone, LH, and FSH serum levels were determined by radioimmunoassay or immunoradiometric assay systems. Clinical outcomes included age at onset, disease duration, Scale for the Assessment and Rating of Ataxia (SARA) score, and progression rate. Univariate general linear models were generated. Testosterone, LH, and FSH serum levels were significantly reduced in male SCA2 patients relative to control individuals. On average, there was a 35% reduction in testosterone levels in male patients versus male control individuals. Testosterone levels were associated with disease duration (r = 0.383; p = 0.025) and age at onset (r = 0.414; p = 0.011) in male SCA2 patients, but no association was observed between testosterone and CAG expansion size, SARA score, or progression rate. Testosterone levels might be a biomarker of disease progression in male SCA2 patients. Further studies are needed to explore the effects of low testosterone levels on non-motor symptoms, and to assess the potential of testosterone replacement therapy in male SCA2 patients.

Human in vitro modeling of adjuvant formulations demonstrates enhancement of immune responses to SARS-CoV-2 antigen.

Adjuvants can enhance vaccine immunogenicity, but their mechanism of action is often incompletely understood, hampering rapid applicability for pandemic vaccines. Herein, we characterized the cellular and molecular activity of adjuvant formulations available for pre-clinical evaluation, including several developed for global open access. We applied four complementary human in vitro platforms to assess individual and combined adjuvants in unformulated, oil-in-water, and liposomal delivery platforms. Liposomal co-formulation of MPLA and QS-21 was most potent in promoting dendritic cell maturation, selective production of Th1-polarizing cytokines, and activation of SARS-CoV-2 Spike-specific CD4+ and CD8+ T cells in a co-culture assay. Select formulations also significantly enhanced Spike antigen-specific humoral immunity in vivo. This study confirms the utility of the cumulative use of human in vitro tools to predict adjuvanticity potential. Thus, human in vitro modeling may advance public health by accelerating the development of affordable and scalable adjuvants for vaccines tailored to vulnerable populations.

Effect of high hydrostatic pressure on mycelial development, spore viability and enzyme activity of Penicillium Roqueforti.

This study investigated the effect of high hydrostatic pressure treatments on mycelial development, spore viability, and total proteolytic and lipolytic activity of Penicillium roqueforti PV-LYO 10 D. Fungus growing in liquid medium was pressure-treated at 300, 400, and 500 MPa for 10 min at 20°C following seven days of incubation at 25°C and analyzed periodically up to day 9 after treatments to evaluate the effect on fungal growth. Mycelial mass of P. roqueforti was significantly affected at all pressure treatments evaluated, being 15.48%, 22.28%, 30.03%, and 12.53% lower than controls on day 1, 3, 6, and 9 after 300 MPa treatment, respectively. In a similar way, at 400 and 500 MPa, mycelial mass was 31.08% and 60.34% lower than controls one day after treatments and 49.74% and 80.85% lower on day 9, respectively. The viability of P. roqueforti spores decreased by 36.53% at 300 MPa, and complete inactivation took place at ≥400 MPa from an initial count of 7 log cfu/mL. Total proteolytic activity was not significantly affected at 300 MPa but was reduced by 18.22% at 400 MPa and by 43.18% at 500 MPa. Total lipolytic activity also decreased as the intensity of the pressure treatments increased. 21.69%, 39.12%, and 56.26% activity reductions were observed when treatments of 300, 400 and 500 MPa were applied, respectively. The results from this study show that pressure treatments are able to control growth, inactivate spores, and alter enzyme activity of P. roqueforti, which could be of interest in extending the shelf-life of blue-veined cheeses and other food products.

Reconstrucción total del párpado superior mediante colgajo frontal / Whole repair made in the upper eyelid using a frontal flap

Los pacientes que han sido sometidos a resecciones quirúrgicas por cáncer, que han sufrido lesiones por quemaduras de espesor total o traumas avulsivos con pérdida extensa de tejidos que engloban la totalidad del párpado superior, acuden con relativa frecuencia a consulta por presentar la cornea expuesta, y dicha exposición resulta en ulceraciones, cicatriz y ceguera. En estos pacientes se observa una gran insatisfacción por el inconveniente que representa no poder usar una prótesis ocular y algo no menos importante, el gran defecto estético. Se presenta el caso de un paciente del sexo masculino, de 30 años de edad, que sufrió múltiples lesiones por el estallido de un artefacto explosivo, con pérdida total del párpado superior derecho y enucleación ocular. Se le realizó reconstrucción palpebral total mediante el colgajo dermograso frontal y se obtuvieron buenos resultados estéticos(AU)

Patients underwent to surgical resections from cancer and whole thickness burn lesions or avulsion traumata with an extent loss of tissues which shape the upper eyelid, came with a relative frequency to consultation due to corneal exposition and this exposition resulting in ulcerations, scar, and blindness. These patients are very unsatisfied because they can not use of an ocular prosthesis, and something less important, the big aesthetic defect. Authors present the case of a male patient aged 30 with multiple lesions from explosion of an explosive artifact with loss of right upper eyelid and ocular enucleation. A total palpebral reconstruction was performed using a frontal dermal fatty flap with good aesthetic results(AU)

Evaluación de los resultados quirúrgicos de la mastoplastia por vía periareolar / Evaluation of the surgical results of mastoplasty by periareolar route

INTRODUCCIÓN. La mayor desventaja de la corrección de la hipertrofia mamaria moderada o la normotrofia asociadas a ptosis de grado I y II reside en las cicatrices visibles. Este trabajo buscó evaluar los resultados de una técnica de plastia mamaria de reducción y suspensión, por vía periareolar. MÉTODOS. En el Servicio de Cirugía Plástica del Hospital Clinicoquirúrgico Hermanos Ameijeiras fueron operadas 24 pacientes a las que se les realizó mastoplastia por vía periareolar. La técnica consistió en el diseño de un colgajo dermograso glandular fijado a la aponeurosis clavipectoral, mediante una incisión circular periareolar, de modo que la mama mantuviera su forma, consistencia y posición. RESULTADOS. Los resultados se evaluaron entre el primer, tercer y sexto mes después de la operación y al año de esta. En el 79,2 por ciento de las pacientes se obtuvieron resultados estéticos. Se corrigió la ptosis mamaria en el 95,7 por ciento de los casos y se logró una proyección anterior de la mama adecuada en el 87,5 por ciento de las pacientes. Solo hubo complicaciones en tres casos y consistieron en lipólisis abscedada y necrosis de la piel. CONCLUSIONES. Con la técnica empleada se lograron buenos resultados estéticos en la mayoría de las pacientes, así como la corrección y reducción de la ptosis y volumen mamario respectivamente, con un mínimo de complicaciones leves(AU)

INTRODUCTION. The greatest disadvantages of the correction of moderate breast hypertrophy or normotrophy associated with I and II degree ptosis are the visible scars. This paper is aimed at evaluating the results of a breast reduction and suspension plasty technique by periareolar route. METHODS. 24 female patients underwent mastoplasty by periareolar route at the Plastic Surgery Service of «Hermanos Ameijeiras¼ Clinical and Surgical Hospital. The technique consisted in the design of a glandular dermofat flap fixed to the clavipectoral aponeurosis by a circular periareolar incision in such a way that the breast would maintain its form, consistency and position. RESULTS. The results were evaluated on the first, third and sixth month, and a year after the operation. Aesthetic results were obtained in 79.2 percent of the patients. Breast ptosis was corrected in 95.7 percent of the cases. An adequate anterior projection of the breast was attained in 87.5 percent of the patients. Only three cases presented complications, which were abscessed lypolisis and skin necrosis. CONCLUSIONS. Good aesthetic results were obtained in most of the patients, as well as the correction and reduction of ptosis and breast volume, respectively, with a minimum of mild complications by using this technique(AU)

Metástasis palpebral de carcinoma renal de células claras: a propósito de un caso / Palpebral metastasis caused by clear cells renal carcinoma: a case presentation

Los párpados están constituidos por diferentes tipos de tejidos, de los cuales pueden desarrollarse diversos tipos histológicos de neoplasias. Se presentó un hombre de 70 años de edad, operado hace 5 años para extirparle un tumor renal, 2 años después, el tumor metastiza al cerebro. Posteriormente, el paciente es ingresado en este hospital y se le realizó exéresis al nivel del borde del párpado izquierdo para eliminar la ptosis mecánica que el tumor le producía y mejorar la visión. El estudio histológico informa un origen renal del tumor.

Eyelids are formed by different types of tissue, from which may be developed many histological types of neoplasia. Authors present the case of a man aged 70, operated on five years ago to excise a renal tumor two years later which metastasizes the brain. Subsequently, patient is admitted in our hospital for exeresis at left eyelid level to eliminate mechanical ptosis provoked by tumor and to improve vision. Histological study reports a renal origin of tumor.

Reconstrucción de la parálisis facial con colgajo del músculo temporal / Reconstruction of facial paralysis with temporalis muscle flap

INTRODUCCIÓN. La transposición de un sistema muscular vital y dinámico en una cara paralizada presenta ventajas biológicas sobre otras técnicas de suspensión que emplean trasplantes musculares de diferentes sitios anatómicos. El objetivo del presente estudio fue describir los resultados, las complicaciones encontradas y la satisfacción de los pacientes tratados mediante transposición del músculo temporal. MÉTODOS. Se realizó una investigación descriptiva y prospectiva con 7 pacientes atendidos entre septiembre de 1997 y julio de 1999. A estos pacientes se les practicó una incisión preauricular que se prolongó hasta la región temporal, en forma de T; se les separó el músculo temporal en toda su extensión y se confeccionaron dos segmentos que a su vez se seccionaron en 4 pequeños colgajos. Se labraron túneles subcutáneos en ambos párpados y labios, donde se introdujeron los colgajos y luego se fijaron al ligamento del canto interno y al tejido celular subcutáneo mediante suturas no absorbibles. El defecto de la fosa temporal fue rellenado con hidroxiapatita en granulado. RESULTADOS. Se obtuvo mejoría en la elevación de la comisura labial en el 100 por ciento de los pacientes operados, pero solo en un paciente (14,3 por ciento) se observó un cierre parcial del ojo. El 87,5 por ciento de los pacientes estuvieron satisfechos con los resultados funcionales obtenidos. Se observaron complicaciones en tres pacientes, las más frecuentes de las cuales fueron la dehiscencia de las suturas musculares, el rechazo al material de relleno y la sepsis local. CONCLUSIONES. Se pudo concluir que esta técnica está indicada en pacientes con secuelas funcionales graves, con atrofia muscular evidente y desviación de la comisura labial(AU)

INTRODUCTION. The transposition of vital and dynamic muscle system in a paralyzed face presents biological advantages over other suspension techniques using muscle transplants from different anatomical sites. The objective of the present study was to describe the results, the complications found and the satisfaction of the patients treated by temporalis muscle transposition. METHODS. A descriptive and prospective research was conducted in 7 patients treated between September 1997 and July 1999. A T-shaped preauricular incision that was prolonged to the temporal region was made. The temporalis muscle was separated in all its extension, the two segments obtained were sectioned into 4 small flaps. Subcutaneous tunnels were made in both eyelids and lips, where the flaps were introduced and fixed then to the ligament of the inner edge and to the subcutaneous cellular tissue by non-absorbable sutures. The defect of the temporal fossa was filled with granulated hydroxyapatite. RESULTS. An improvement of the elevation of the lip commissure was attained in 100 percent of the patients that were operated on, A partial closure of the eye was observed in only one patient (14.3 percent). 87.5 percent of the patients were satisfied with the functional results. Complications were reported in 3 patients. The most frequent were dehiscence of the muscle sutures, the rejection to the filling material and local sepsis. CONCLUSIONS. It was concluded that this technique is indicated in patients with severe functional sequelae, with muscle atrophy and deviation of the lip commissure(AU)

Evaluación de la vía aérea en el niño / Evaluation of the airway in the children

La intubación endotraqueal se ha convertido en una práctica corriente dentro de la anestesiología moderna. Sin embargo, en ocasiones sorprende la dificultad o la imposibilidad de efectuarla aun en manos experimentadas. Por esta razón se hace necesaria la predicción de la dificultad o facilidad que nos ofrezcan las características anatómicas de cada paciente. En el niño, debido a la falta de de cooperación al examen físico y de pruebas específicas que puedan predecir una vía aérea difícil, la evaluación de la misma difiere de la del adulto. En la presente revisión se describen las características anatómicas y fisiológicas del aparato respiratorio del niño de interés para el anestesiólogo, y se señalan los elementos a tener en cuenta para la valoración de la vía aérea en el paciente pediátrico...

Uso de la jalea de aloe en la cervicitis aguda / Use of aloe gel in acute cervicitis

Se realiza un ensayo clínico a doble ciegas en un grupo de pacientes con cervicitis aguda, las cuales fueron atendidas en los policlínicos "Jorge Ruíz Ramírez" y "26 de Julio", del municipio Playa. Se analizaron diferentes síntomas y signos así como la respuesta al tratamiento con curas de aloe. Se concluye que el aloe es efectivo en el tratamiento de esta entidad y que se incrementan sus resultados favorables cuando se asocia con ácido láctico